The University of Melbourne, Melbourne, VIC.
Med J Aust. 2022 Sep 5;217(5):262-267. doi: 10.5694/mja2.51678. Epub 2022 Aug 21.
Breast cancer is the commonest human cancer globally and one in seven Australian women will develop it in their lifetime. Surgery is the mainstay of management both for women who are at high risk of breast cancer and for those who have been diagnosed. Increased understanding of how to predict who is most at risk of breast cancer is leading to the possibility of risk-based screening, allowing better and more targeted early detection for women at high risk, and contrast imaging techniques are proving more accurate in diagnosing and staging cancer. The evolution of surgical practice includes the widespread use of oncoplastic surgery, allowing better cosmetic and oncological outcomes; reconstructive surgical advances, using free flap techniques; and sequencing of systemic and local therapies to better tailor treatments to the patient's cancer and improve outcomes. Recognition of side effects of breast cancer treatment have led to improvement in the management of conditions such as chronic pain and lymphoedema, as well as addressing the psychosocial, body image and sexual complications caused by the cancer and its treatment.
乳腺癌是全球最常见的人类癌症，每七个澳大利亚女性中就有一个会在其一生中患上乳腺癌。手术是管理高危乳腺癌患者和已确诊患者的主要方法。对如何预测谁最有患乳腺癌风险的理解不断加深，使得基于风险的筛查成为可能，为高危女性提供更好、更有针对性的早期检测，并且对比成像技术在诊断和分期癌症方面更为准确。手术实践的发展包括广泛使用肿瘤整形手术，以获得更好的美容和肿瘤学结果；使用游离皮瓣技术的重建手术进展；以及对全身和局部治疗方案的排序，以更好地根据患者的癌症情况调整治疗方案，提高治疗效果。对乳腺癌治疗副作用的认识，导致对慢性疼痛和淋巴水肿等疾病的管理得到改善，同时也解决了癌症及其治疗引起的心理社会、身体形象和性功能并发症。
